Download or read book Oversight Challenges in the Medicare Prescription Drug Program written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security and published by . This book was released on 2010 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Does CMS Have the Right Prescription written by United States. Congress. Senate. Committee on Governmental Affairs. Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia and published by . This book was released on 2004 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Part D Prescription Drug Coverage written by Jennifer R. Luong and published by DIANE Publishing. This book was released on 2010-03 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: The outpatient prescription drug benefit known as Medicare Part D was first available in Jan. 2006, and that year it provided federally subsidized prescription drug coverage for nearly 28 million beneficiaries at a cost of $47.4 billion -- almost 12% of total Medicare spending. Part D sponsors -- entities that enter into contracts with Medicare -- administer the benefit and compete for beneficiary enrollment. To provide coverage, the sponsors enter into contractual relationships with pharmacy benefit managers, drug manufacturers, and retail pharmacies. The Part D program relies on sponsors to generate prescription drug savings, in part through their ability to negotiate price concessions, such as rebates and discounts, with these entities.
Download or read book Monitoring CMS Vital Signs written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia and published by . This book was released on 2006 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Printed for the use of the Committee on Homeland Security and Governmental Affairs."
Download or read book Medicare Part D written by Kathleen M. King and published by DIANE Publishing. This book was released on 2009-02 with total page 43 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare Part I coverage is provided through plan sponsors that contract with CMS. As of April 2008, 26 million beneficiaries were enrolled in Part D. When beneficiaries encounter problems with Part D, they can either file a complaint with CMS or a grievance with their plan sponsors. CMS tracks complaints data and plan sponsors report data on grievances. This report provides info. on: (1) complaints and what they indicate about beneficiaries¿ experiences with Part D; (2) whether grievances data provide additional insight about beneficiaries¿ experiences; and (3) CMS¿s oversight of the complaints and grievances processes. Illus. (This report was changed as of 7/1/08 to add Appendix II, which is the agency comment letter that was left out of the report.)
Download or read book Medicare Part D written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-10-05 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2014, the federal government spent $58 billion on Medicare Part D, the voluntary, outpatient prescription drug coverage program. An estimated $1.9 billion of this total was improper payments-including overpayments or underpayments that may be due to errors, such as the submission of duplicate claims for the same service. In January 2011, CMS began a RAC program in Part D that was intended in part to identify and recoup improper payments, as required under the Patient Protection and Affordable Care Act. The RAC is paid a contingency fee from amounts recovered. GAO was asked to review CMS's Part D RAC program implementation, oversight, and results. GAO examined (1) how CMS has implemented the Part D RAC program and any challenges it faced during implementation; (2) the extent to which CMS has overseen the RAC's audit activities; and (3) the results of the RAC's work to date and any challenges CMS and the RAC faced in identifying and collecting improper payments. To do this, GAO analyzed the RAC contract and audit documents, and federal statutes and regulations on Part D and federal contracting. GAO also interviewed CMS and RAC officials.
Download or read book The Medicare Handbook written by and published by . This book was released on with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Download or read book Report to the President written by and published by . This book was released on 2000 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt: On October 25,1999, the President directed the Secretary of Health and Human Services to study prescription drug costs and trends for Medicare beneficiaries. He asked that the study investigate: price differences for the most commonly used drugs for people with and without coverage; drug spending by people of various ages, as a percentage of income and of total health spending; and trends in drug expenditures by people of different ages, as a percentage of income and of total health spending. This report is the Department's response to that request. It represents the work of individuals and agencies throughout the Department, including the Agency for Healthcare Research and Quality (AHRQ), the Food and Drug Administration (FDA), the Health Care Financing Administration (HCFA), and the Office of the Assistant Secretary for Planning and Evaluation (ASPE).
Download or read book The Role of NIH in Drug Development Innovation and Its Impact on Patient Access written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-01-27 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt: To explore the role of the National Institutes of Health (NIH) in innovative drug development and its impact on patient access, the Board on Health Care Services and the Board on Health Sciences Policy of the National Academies jointly hosted a public workshop on July 24â€"25, 2019, in Washington, DC. Workshop speakers and participants discussed the ways in which federal investments in biomedical research are translated into innovative therapies and considered approaches to ensure that the public has affordable access to the resulting new drugs. This publication summarizes the presentations and discussions from the workshop.
Download or read book Prescription Drugs Oversight of Drug Pricing in Federal Programs written by and published by DIANE Publishing. This book was released on 2007 with total page 18 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Fraud Waste and Abuse Challenges and Strategies for Preventing Improper Payments written by Kathleen M. King and published by DIANE Publishing. This book was released on 2010-10 with total page 15 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare¿s size and complexity make it vulnerable to fraud, waste, and abuse. Fraud represents intentional acts of deception with knowledge that the action or representation could result in an inappropriate gain, while abuse represents actions inconsistent with acceptable bus. or med. practices. Waste, which includes inaccurate payments for services, also occurs in the Medicare program. In 2009, the Centers for Medicare and Medicaid Services (CMS) estimated billions of dollars in improper payments in the Medicare program. This statement focuses on challenges facing CMS and selected key strategies that are particularly important to helping prevent fraud, waste, and abuse, and ultimately to reducing improper payments. Illustrations.
Download or read book Preventing and Recovering Medicare Payment Errors written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security and published by . This book was released on 2011 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Activities of the Committee on Homeland Security and Governmental Affairs written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs and published by . This book was released on 2012 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Quality and cost standards for drugs written by United States. Task Force on Prescription Drugs and published by . This book was released on 1969 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Federalism and Health Policy written by Alan Weil and published by The Urban Insitute. This book was released on 2003 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.
Download or read book Allegations of Waste Fraud and Abuse in Pharmaceutical Pricing written by United States. Congress. House. Committee on Oversight and Government Reform and published by . This book was released on 2007 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt:
